“CRP elevation represents a more significant threshold of mucosal damage compared with endoscopic assessment.” “In our study, 37% of the silent Crohn’s disease cohort [with elevated CRP] at our center required hospitalization within 2 years compared with 7% of patients who felt well and had no elevation of CRP level.”

These findings reinforce the notion that mucosal healing in combination with symptoms is important at predicting long-term response to treatment. A commonly-used physician global assessment may miss silent CD.

Bottomline: In those with “inactive” CD, obtaining a CRP (and possibly a fecal calprotectin) will improve detection of silent CD.